臨床 Prostaglandin E1による動脈管拡張,閉鎖阻止 長期間投与の試みと副作用
過去2年間に,肺動脈閉鎖を伴った9例に対し動脈管拡張を目的とし,Prostaglandin E1を経静脈投与した.投与後8例に動脈血酸素分圧の上昇を認め有効であった.合併奇形の存在,成長に伴う短絡手術手技・術後管理難易の変化,および動脈管壁器質化による永続する開存性などを考慮し,可能なかぎり長期投与を行った.投与中種々の副作用を認めたが血圧下降,低ナトリウム血症,発熱,痙攣が主なものであった.しかし,多くは対症的に克服できるものであった.また間歌投与法を取り入れることにより,副作用出現頻度も低下するように思われた....
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| Published in | 心臓 Vol. 11; no. 5; pp. 507 - 513 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
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公益財団法人 日本心臓財団
25.05.1979
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0586-4488 2186-3016 |
| DOI | 10.11281/shinzo1969.11.5_507 |
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| Abstract | 過去2年間に,肺動脈閉鎖を伴った9例に対し動脈管拡張を目的とし,Prostaglandin E1を経静脈投与した.投与後8例に動脈血酸素分圧の上昇を認め有効であった.合併奇形の存在,成長に伴う短絡手術手技・術後管理難易の変化,および動脈管壁器質化による永続する開存性などを考慮し,可能なかぎり長期投与を行った.投与中種々の副作用を認めたが血圧下降,低ナトリウム血症,発熱,痙攣が主なものであった.しかし,多くは対症的に克服できるものであった.また間歌投与法を取り入れることにより,副作用出現頻度も低下するように思われた. |
|---|---|
| AbstractList | 過去2年間に,肺動脈閉鎖を伴った9例に対し動脈管拡張を目的とし,Prostaglandin E1を経静脈投与した.投与後8例に動脈血酸素分圧の上昇を認め有効であった.合併奇形の存在,成長に伴う短絡手術手技・術後管理難易の変化,および動脈管壁器質化による永続する開存性などを考慮し,可能なかぎり長期投与を行った.投与中種々の副作用を認めたが血圧下降,低ナトリウム血症,発熱,痙攣が主なものであった.しかし,多くは対症的に克服できるものであった.また間歌投与法を取り入れることにより,副作用出現頻度も低下するように思われた. |
| Author | 辻, 敦敏 郡, 建男 森川, 良行 木村, 和弘 小佐野, 満 宮崎, 勇 石井, 忠信 |
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| References | 8) Fraser, I. S.: Electroencephalogram changes after prostaglandin. Lancet, 1: 360, 1974. 22) Coceani, F. & 011ey, P. M.: The response of the ductus arteriosus to prostaglandins. Can. J. Physiol. Pharmacol., 51: 220, 1973. 24) Clyman, R. I., Heymann, M. A. & Rudolph, A. M.: Ductus arteriosus responses to prostaglandin E1 at high and low oxygen concentrations. Prostaglandins. 13: 219, 1977. 28) Elliott, R. B., Starling, M. B. & Neutze, J. M.: Medical manipulation of the ductus arteriosus. Lancet, 1: 140, 1975. I) Wilson, D. E.: Prostaglandins, "their action on the gastrointestinal tract". Arch. Intern. Med., 133: 112, 1974. 30) Olley, P. M. Coceani, F. & Bodach, E.: E type prostaglandins "a new emergency therapy for cert a in cyanotic congengenital malformations". Circulation, 53: 728, 1976. 4) Milton, A. S. & Wendlandt, S.: A possible role for prostaglandin El as a modulator for temperatur e regulation in the central nervous system of the cat. J. Physiol., 207: 76, 1970. 6) Horton, E. W.: Action of prostaglandin E1, E2 and E3 on the central nervous system. Br. J. Pharmaco l., 22: 189, 1964. 15) Kadowitz, P. J., Joiner, P. D., Hyman, A. L. &George, W. J.: Influence of prostaglandin E1 and F2a on pulmonary vascular resistence, isolated lobar vessels and cyclic nucleotide levels. J. Pharmacol. Exp. Ther., 192: 677, 1975. 31)郡建男, 小佐野満: PGE董による動脈管拡張, 閉鎖阻止の試み. 第12回小児循環器研究会, 昭和51年7月26日 於京都 2) Bennet, A. & Fleshier, B.: Prostaglandins and the gastrointestinal tract. Gastroenterology, 59: 790, 1970. 3) Karim, S. M. M. & Adaikan, P. G.: The effect of Loperamide on prostaglandin induced diarrhea in rat and man. Prostaglandins, 13: 321, 1977. 10) Stokes, J. B. & Kokko, J. P.: Inhibition of sodium transport by prostaglandin E2 across the isolated, perfused rabbit collecting tubule. J. Clin I nvest., 59: 1099, 1977. 23) Starling, M. B. & Elliott, R. B.: The effect of prostaglandins, prostaglandin inhibitors and oxygen on the closure of the ductus arteriosus, pulm onary arteries and umbilical vessels in vitro. prostaglandins, 8: 187, 1974. 5) Lee, J. B.: Cardiovascular renal effect of prostaglandins, "the antihy pertensive, natriuretic renal "endocrine"functinn". Arch. Intern. Med., 133: 56, 1974. 18) Born, G. V. R., Dawes, G. S., Mott, J. C. & Rennick, B. B.: The constriction of the ductus a r teriosus caused by oxygen and by asphyxia in newborn lambs. J. Physiol., 132: 304, 1956. 17) Barcroft, J., Kennedy, J. A. & Mason M. F.: The relation of the vagus nerve to the ductus arteriosus in the guinea pig. J. Physiol., 92: 1, 1938. 19) Kovaleik, V.: The response of the isolated ductus arteriosus to oxygen and anoxia. J. Physiol., 169: 185, 1963. 27) Rudolph, A. M., Heymann, M. A., Fishman, N. &Lakier, J. B.: Formallin infiltration of the ductus arteriosus "a method for palliation of infant with selected congenital cardiac lesions". N. Engl. J. Med., 292: 1263, 1975. 11) Zurier, R. B.: Prostaglandins, inflammation and asthma. Arch. Intern. Med., 133: 101, 1974. 32)上村茂, 門間和夫, 高尾篤良: チアノーゼ性先天性心疾患に対するPGE1投与の経験. 第12回小児循環器研究会, 昭和51年7月26日 於京都 34) Moulaert, A. J., Gittenberger, A. G. & Harinck, E.: Prostaglandin and damage to ductus arteriosus Lancet, 1: 703, 1977. 26) Coceani, F., 011ey, P. M. & Bodach, E.: Lamb ductus arteriosus: effect of prostaglandin synthesis inhi bitors on the muscle tone and the response to prostaglandin E2. Prostaglandins, 9: 299, 1975. 13) Scaramuzzi, O. E., Baile, C. A. & Mayer, J.: Prostaglandins and food intake of rats. Experientia, 27: 256, 1971. 14) Allen, J. E. & Valeri, R.: Prostaglandins in hematology. Arch. Intern. Med., 133: 86, 1974. 16) Rivkin, I., Rosinblatt, T. & Becker, E. L.: The role of cyclic AMP in the chemotactic responsiveness a n d spontaneous motility of rabbit peritoneal neutrophi l s. J. Immunol., 115: 1126, 1975. 21) Aronson, S., Gennser, G., Ownan, CH. & Sjoberg, N. O.: Innervation and contractile response of the human ductus arteriosus. Eur, J. Pharmacol., 11: 178, 1970. 25) Sharpe, G. L., Thalme, B. & Larsson, K. S.: Studies on closure of the ductus arteriosus. XT. ductal closure in utero by a prostaglandin synthetase inhibitor. Prostaglandins, 8: 363, 1975. 20) Moss, A. J., Emmanouilides, G. & Duffle, E. R. Jr.: Closure of the ductus arteriosus in the newborn infant. Pediatrics, 32: 25, 1963. 7) Coceani, F.: Prostaglandins and the central nervous system. Arch. Intern. Med., 133: 119, 1974. 9) Macgiff, J. C., Crowshaw, K. & Itskovitz, H. D.: Prostaglandins and renal function. Fed. Proc., 33: 39, 1974. 33) Neutze, J. M., Starling, M. B., Elliott, R. B. &Barrat-Boyes, B. G.: Palliation of cyanotic congenita l heart disease in infancy with E-type prostaglandins. Circulation, 55: 238, 1977. 29)郡建男, 小佐野満, 肺動脈閉鎖症例に対するPGE1投与の経験第266回日本小児科学会東京地方会昭和51年2月14日 12) Sendergaard, J. & Greaves, M. W.: Prostaglandin E1; effect on human cutaneous vasculature and skin histamine. Br. J. Dermatol., 84: 424, 1971. |
| References_xml | – reference: 26) Coceani, F., 011ey, P. M. & Bodach, E.: Lamb ductus arteriosus: effect of prostaglandin synthesis inhi bitors on the muscle tone and the response to prostaglandin E2. Prostaglandins, 9: 299, 1975. – reference: 5) Lee, J. B.: Cardiovascular renal effect of prostaglandins, "the antihy pertensive, natriuretic renal "endocrine"functinn". Arch. Intern. Med., 133: 56, 1974. – reference: 9) Macgiff, J. C., Crowshaw, K. & Itskovitz, H. D.: Prostaglandins and renal function. Fed. Proc., 33: 39, 1974. – reference: I) Wilson, D. E.: Prostaglandins, "their action on the gastrointestinal tract". Arch. Intern. Med., 133: 112, 1974. – reference: 10) Stokes, J. B. & Kokko, J. P.: Inhibition of sodium transport by prostaglandin E2 across the isolated, perfused rabbit collecting tubule. J. Clin I nvest., 59: 1099, 1977. – reference: 4) Milton, A. S. & Wendlandt, S.: A possible role for prostaglandin El as a modulator for temperatur e regulation in the central nervous system of the cat. J. Physiol., 207: 76, 1970. – reference: 34) Moulaert, A. J., Gittenberger, A. G. & Harinck, E.: Prostaglandin and damage to ductus arteriosus Lancet, 1: 703, 1977. – reference: 8) Fraser, I. S.: Electroencephalogram changes after prostaglandin. Lancet, 1: 360, 1974. – reference: 3) Karim, S. M. M. & Adaikan, P. G.: The effect of Loperamide on prostaglandin induced diarrhea in rat and man. Prostaglandins, 13: 321, 1977. – reference: 18) Born, G. V. R., Dawes, G. S., Mott, J. C. & Rennick, B. B.: The constriction of the ductus a r teriosus caused by oxygen and by asphyxia in newborn lambs. J. Physiol., 132: 304, 1956. – reference: 22) Coceani, F. & 011ey, P. M.: The response of the ductus arteriosus to prostaglandins. Can. J. Physiol. Pharmacol., 51: 220, 1973. – reference: 15) Kadowitz, P. J., Joiner, P. D., Hyman, A. L. &George, W. J.: Influence of prostaglandin E1 and F2a on pulmonary vascular resistence, isolated lobar vessels and cyclic nucleotide levels. J. Pharmacol. Exp. Ther., 192: 677, 1975. – reference: 32)上村茂, 門間和夫, 高尾篤良: チアノーゼ性先天性心疾患に対するPGE1投与の経験. 第12回小児循環器研究会, 昭和51年7月26日 於京都 – reference: 2) Bennet, A. & Fleshier, B.: Prostaglandins and the gastrointestinal tract. Gastroenterology, 59: 790, 1970. – reference: 27) Rudolph, A. M., Heymann, M. A., Fishman, N. &Lakier, J. B.: Formallin infiltration of the ductus arteriosus "a method for palliation of infant with selected congenital cardiac lesions". N. Engl. J. Med., 292: 1263, 1975. – reference: 12) Sendergaard, J. & Greaves, M. W.: Prostaglandin E1; effect on human cutaneous vasculature and skin histamine. Br. J. Dermatol., 84: 424, 1971. – reference: 23) Starling, M. B. & Elliott, R. B.: The effect of prostaglandins, prostaglandin inhibitors and oxygen on the closure of the ductus arteriosus, pulm onary arteries and umbilical vessels in vitro. prostaglandins, 8: 187, 1974. – reference: 30) Olley, P. M. Coceani, F. & Bodach, E.: E type prostaglandins "a new emergency therapy for cert a in cyanotic congengenital malformations". Circulation, 53: 728, 1976. – reference: 7) Coceani, F.: Prostaglandins and the central nervous system. Arch. Intern. Med., 133: 119, 1974. – reference: 20) Moss, A. J., Emmanouilides, G. & Duffle, E. R. Jr.: Closure of the ductus arteriosus in the newborn infant. Pediatrics, 32: 25, 1963. – reference: 31)郡建男, 小佐野満: PGE董による動脈管拡張, 閉鎖阻止の試み. 第12回小児循環器研究会, 昭和51年7月26日 於京都 – reference: 6) Horton, E. W.: Action of prostaglandin E1, E2 and E3 on the central nervous system. Br. J. Pharmaco l., 22: 189, 1964. – reference: 11) Zurier, R. B.: Prostaglandins, inflammation and asthma. Arch. Intern. Med., 133: 101, 1974. – reference: 25) Sharpe, G. L., Thalme, B. & Larsson, K. S.: Studies on closure of the ductus arteriosus. XT. ductal closure in utero by a prostaglandin synthetase inhibitor. Prostaglandins, 8: 363, 1975. – reference: 21) Aronson, S., Gennser, G., Ownan, CH. & Sjoberg, N. O.: Innervation and contractile response of the human ductus arteriosus. Eur, J. Pharmacol., 11: 178, 1970. – reference: 14) Allen, J. E. & Valeri, R.: Prostaglandins in hematology. Arch. Intern. Med., 133: 86, 1974. – reference: 13) Scaramuzzi, O. E., Baile, C. A. & Mayer, J.: Prostaglandins and food intake of rats. Experientia, 27: 256, 1971. – reference: 28) Elliott, R. B., Starling, M. B. & Neutze, J. M.: Medical manipulation of the ductus arteriosus. Lancet, 1: 140, 1975. – reference: 19) Kovaleik, V.: The response of the isolated ductus arteriosus to oxygen and anoxia. J. Physiol., 169: 185, 1963. – reference: 24) Clyman, R. I., Heymann, M. A. & Rudolph, A. M.: Ductus arteriosus responses to prostaglandin E1 at high and low oxygen concentrations. Prostaglandins. 13: 219, 1977. – reference: 17) Barcroft, J., Kennedy, J. A. & Mason M. F.: The relation of the vagus nerve to the ductus arteriosus in the guinea pig. J. Physiol., 92: 1, 1938. – reference: 16) Rivkin, I., Rosinblatt, T. & Becker, E. L.: The role of cyclic AMP in the chemotactic responsiveness a n d spontaneous motility of rabbit peritoneal neutrophi l s. J. Immunol., 115: 1126, 1975. – reference: 33) Neutze, J. M., Starling, M. B., Elliott, R. B. &Barrat-Boyes, B. G.: Palliation of cyanotic congenita l heart disease in infancy with E-type prostaglandins. Circulation, 55: 238, 1977. – reference: 29)郡建男, 小佐野満, 肺動脈閉鎖症例に対するPGE1投与の経験第266回日本小児科学会東京地方会昭和51年2月14日 |
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| SubjectTerms | 動脈管 肺動脈閉鎖 |
| Subtitle | 長期間投与の試みと副作用 |
| Title | 臨床 Prostaglandin E1による動脈管拡張,閉鎖阻止 |
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